在美國利潤至上的醫療體系裡，像巴迪亞醫生(Dr. Luis Padilla) 這種對金錢置之不顧的醫生非常少見。巴迪亞在華盛頓一個困厄潦倒的貧民區，哥倫比亞嶺，做醫生。他的病人大多數沒有醫療保險或只有不足夠的保險。到他的《團結醫療中心》看病的，90% 以上的病人是黑人和拉丁裔。
可是他發現，這種現象已漸漸改變了，越來越多看病的是歐裔人了。這個新現象，是當前美國醫療系統正在加速變化的縮影。他說，“他們是我的《煤礦里的金絲鳥》(Canary in the coal mine 災難來臨的先兆)。這些歐裔病人本來是有保險的，但他們被解僱後失去了保險，他們來看病時，好幾個月都沒吃了藥，健康情況已進入很嚴重的處境。如果他們需要乳房X 光照或癌症治療，這些昂貴的醫療費誰能付出來呢？”
註： 此文章部分摘自加拿大環球郵報專欄作者KONRAD YAKABUSKI 2010年3月20日發表文章 (Obama makes final push for health bill) 和CNBC.com 同日文章(After Decades of Failure - New Health Law Seems Near).
Zhao Jun, You know what they say about opening a can of worms. Haha.
I can see you feel very strongly about this topic, and so do most Americans (on either side of the ideological divide), obviously.
It’s too bad we (that’s the “royal” we, since Canadians don’t get to vote on this one) don’t get to choose between the war in Iraq/Afghanistan and Health Care Reform.
(I know, I know, the “war” too,is a can of worms. And, I might also add, that one is a legacy of the 2 Bushes, )
The crux of the problem is that the U.S. budgetary challenge is simply too humongous.
Now let’s see everybody fight over this one (i.e. the budget deficit).
Having said that, I am glad, Zhao Jun, that you chose my forum to speak up.
TCW: I guess I should keep my mouth shut about this topic after the heated debate at my blog, but just can't resist to comment one more time on this topic because of your reference to Medicare and Social Security in the text and the reference to CBO projection. I agree with Ouyang Feng, the comparison of this "reform" and the Medicare and Social Security is such an ironic one, because the other two are both broken beyond repair and we all know that (interestingly, no one is talking about fixing the social security system - why? And now the Medicare is going to get cut to finance this health care reform). So the media's praise of Obama's achievement as "another milestone in US history, just like Medicare and Social Security", just amuses me. I'm sorry- I'm a bit cynical here.
In terms of CBO projection, I just heard the other day that CBO "projected" in 1965 (the year Medicare was passed) that in 2010 (incidently, this year) the total spending of the Medicare system will be $60 billion. Guess how much the actual cost will be this year? $480 billion - 8 times their projection!!! I know out of all the federal agencies, the bipartison CBO's projections are the most reliable (isn't that scary? Just look at how the government keeps "adjusting" the unemployment rate every month, you know "cooking data" is not a specialty of the Chinese government), and projecting is a tricky game, I know, but doesn't that provide some context and caution if we just take their projection at the face value?
I have to say it again in the end, I'm all for providing healthcare for people who can't afford them, and I totally understand that if they don't have at least minimum coverage, the taxpayers are going to pay in the end one way or the other. I just don't think this way of creating an even bigger government agency and arbitrarily increasing tax (how do you impose "payroll tax" on income from divident, interest, and rental activities?!) is the way to do and is not sustainable at all. It will affect everyone pretty soon.
Sorry for the ranting. I just need to put those words out somewhere:)).
Sir/Madam, are you a Canadian? If you're not, then may I suggest you've been mis-informed? "Rethinking" is too strong a word. Universal health care is so entrenched here there would be riots in the streets if there was any hint of "rethinking". But it IS evolving. That's because cost containment is an important consideration. As will the U.S. version.
Please also see my answer to “buzz”.
Incidentally, the CBO projects a net surplus for the cost of health care reform over 10 years (though that estimate may be subject to debate), and the tax burden is to be borne largely by those making over $200,000/year.
Just for comparison, according to one estimate, the war in Iraq and Afghanistan has to-date cost $1.05 TRILLION and rising. Who do you thinking has been paying for that?
Ironicaly this article is written by a Canadian, whose country is rethinking its broken universal health care. Helping the poor is not mere chanting of "yes we can", and tax-hike will quickly effect to every citizen of USA.
I agree that healthcare must be taken care of. But it's such a profound reform, proper political consensus is very important. Railroading the opponents is a sure fire way to get into more trouble.
歐陽， You're absolutely right. Paying for entitlement programs is, as they say, always a "64,000-dollar question" (here's another English idiom for you, haha.) But, and this is a big BUT, if we believe in a humane society, then we must find the way. I think Obama (or whoever comes next) will begin to tackle it after Health care Reform. After all is said and done (that's another idiom), however, we cannot deny the historical significance of what President Johnson did. Don't you agree?
To remove "precondition exclusion", there must be universal insurance coverage. Otherwise it's just economically unfeasible. But to realize universal coverage, the cost must be covered (concealed) with other "reforms". So there is no easy solution.
It may not be good idea to equate Obamacare with Social Security or Medicare: both of these systems are in deep financial trouble now.
